Systematic screening for diabetic retinopathy with a digital fundus camera following pupillary dilatation in a university diabetes department.

AIMS: Screening for diabetic retinopathy (DR) is highly inadequate in France because of insufficient infrastructure and increasing disease prevalence. We describe the results of the first systematic DR screening programme established in a university diabetes department. METHODS: In this cross-sectional study conducted over 1 year, consecutive adult patients underwent three-field retinal photography with the Topcon TRC NW6S digital fundus camera following pupillary dilatation with Tropicamide 1%. A questionnaire provided information on patients' systemic and ocular history. Glycated haemoglobin (HbA1c) was measured at the screening visit.Two ophthalmologists graded the retinal photographs in a masked fashion. RESULTS: Of 1157 patients attending the diabetes department, 1153 (99.7%)underwent photographic screening. Images were gradable in 96% patients.Diabetic retinopathy was detected in 522 (45%) patients and sight-threatening DR in 167 (14%). Of 704 (61%) patients previously believed to have no DR,254 (34%) screened positive. The presence of DR was associated with age,insulin use and non-Caucasian ethnicity in Type 2 patients, and with duration of diabetes and HbA1c in Type 1 and Type 2 patients. Associated ocular pathologies were diagnosed in 612 (53%) patients. CONCLUSIONS: Our photographic screening programme using pharmacological mydriasis provided a high screening coverage feasible in a hospital setting. We obtained information regarding prevalence and associated risk factors of DR inpatients attending a tertiary care centre. Screening was well accepted by patients and met with no protest from city ophthalmologists. It generated considerable interest among endocrinologists and feedback of results is expected to improve optimization of glycaemic control.     

社会能力评定量表的编制及信效度检验

目的：编制社会能力评定量表并检测其信度和效度。方法：在全国五大行政区用社会能力评定量表评估1605例正常人(男性814名，女性791名)，分析量表的信效度。结果：全量表的Cronbach's α系数为0．88-0．92，三个分量表的d系数为0．81～0．88；量表的分半信度为0．76～0．87，量表的重测信度为0．67～0．86，量表评分者信度为0．91～0．97，表明量表具有较好的内部一致性和稳定性；各条目与总分的相关系数0．49-0．80，分量表与总分的相关系数为0．76～0.89，通过因子分析，证实了量表的结构效度；全量表总分和职业能力得分与被试单位提供的实际社会能力评分呈高度相关，与韦氏智商呈中低度相关。结论：量表编制符合心理测量学要求，具有良好的信度和效度。     

早年父亲去世的心理创伤研究——1例男大学生的深入访谈分析

目的 探讨男孩8岁时父亲去世对其带来的创伤影响。方法 运用质的研究方法，对一名在8岁时经历父亲去世的男大学生进行深入访谈，采用主要概念或主题突出分类的方法进行编码分析。结果 父亲去世使个体产生了强烈的不安全感，严重的自卑感和神经症性的防御机制。结论 父亲去世后，家庭氛围是影响孩子心理健康的重要因素。     

单侧入路椎体后凸成形术治疗老年骨质疏松性胸腰椎压缩性骨折临床研究

目的：探讨单侧入路椎体后凸成形术治疗老年骨质疏松性胸腰椎压缩性骨折的临床疗效和安全性。方法：将15例老年骨质疏松性胸腰椎压缩性骨折患者，行单侧入路穿刺椎体后凸成形术。记录手术时间和透视次数，观察术后患者背痛缓解程度及日常活动恢复情况，比较术前、术后伤椎高度和脊柱后凸畸形Cobb’S角。结果：15例患者均顺利完成手术，手术时间25～43min，平均28．6min；透视次数15～23次，平均19．8次；术后伤椎前部、中部高度，脊柱后凸畸形Cobb’S角与术前比较，差异有统计学意义（P〈0．05）；术后24h患者背痛均明显缓解，与术前比较差异有统计学意义（P〈0．05）。患者均能在术后次日下床行走，未发现神经损伤等手术并发症。结论：单侧入路穿刺球囊扩张椎体后凸成形术能有效地治疗老年骨质疏松性胸腰椎压缩性骨折，且操作简便、安全，能明显地减少患者和术者的放射暴露。     

炙甘草汤对大鼠室性早搏拮抗作用实验研究

目的：观察炙甘草汤对鸟头碱所致大鼠室性早博的预防和治疗作用。方法：成年SD大鼠50只，随机分为炙甘草汤大剂量组、中剂量组、小剂量组、生理盐水组、普萘洛尔组分别用相应药物及生理盐水灌胃5天后，匀速舌下静脉注射乌头碱，与生理参数分析仪相连接，观察心律失常的潜伏期及持续时间。结果：延长室性早搏的潜伏期炙甘草汤高、中剂量组与生理盐水纽比较有显著性差异（P〈0．05），普萘洛尔组与炙甘草汤高、中剂量组比较无显著性差异（P〉0．05）。缩短室性旱搏持续时间炙甘草汤高剂量组与生理盐水组比较有极显著差异（P〈0．01），炙甘草汤中剂量组与生理盐水组比较有显著性差异（P〈O．05），普萘洛尔组与炙甘草汤高、中剂量组比较无显著差异（P〉0．05），与生理盐水比较有极显著差异（P〈0．01）。结论：炙甘草汤对乌头碱所致大鼠室性早搏有一定的预防及治疗作用。     

Development of the student placement evaluation form: A tool for assessing student fieldwork performance

Evaluation of students undertaking fieldwork education placements is a critical process in the health professions. As training programs and practice evolve, systems for assessing students need to be reviewed and updated constantly. In 1995, staff of the occupational therapy training program at the University of Queensland, Australia decided to develop a new tool for assessing student fieldwork performance. Using an action research methodology, a team developed the Student Placement Evaluation Form, a flexible and comprehensive criterion-referenced evaluation tool. The present paper examines action research as an appropriate methodology for considering real-life organisational problems in a systematic and participatory manner. The action research cycles undertaken, including preliminary information gathering, tool development, trial stages and current use of the tool, are detailed in the report. Current and future development of the tool is also described.     

无名异冲剂促进去卵巢大鼠骨质疏松性骨折愈合的机制研究

为探讨无名异冲剂促进去卵巢 SD大鼠骨质疏松性骨折愈合的机制 ,用 48只 6月龄雄性 SD大鼠建立骨质疏松性骨折模型 ,随机分为模型组、跳骨片组、仙灵骨葆组、无名异冲剂组 ,于灌胃后 2周、4周取材 ,观察 X线片、骨密度、光镜 ,骨痂钙、磷、胶原含量 ,结果显示灌胃第 2周时 ,各组动物各项指标均无显著性差异 ;第4周时 ,无名异冲剂组的骨密度 ,骨痂钙、磷、胶原含量的检测结果与模型组有显著性差异 ( P<0 .0 5 ) ,X线及光镜观察骨痂的生长情况 ,无名异冲剂组也优于模型组 ,说明无名异冲剂能够通过提高骨密度 ,改善骨骼钙、磷、胶原的代谢 ,促进骨折端骨痂的生长 ,达到治疗骨质疏松性骨折的目的。     

对新调入护士进行专科知识教育的体会

目的探讨如何对新调入肿瘤科的护士进行专科教育的有关问题。方法帮助新护士尽快适应工作环境，进行必要的专科知识教育和专科技术传授，熟练掌握肿瘤病人的心理特点及健康教育技巧。结果新护士在调入1个月后能单独完成本职工作，未发生差错和事故，同事对新调入护士评价好，病人满意。结论护士长对新调入护士有目的地进行专科理论知识教育和专科技术操作传授，言传身教，对尽快提高新调入护士的工作能力，确保护理质量起着重要的作用。     

提高与保证生物化学教学质量的探讨

随着生物化学和分子生物学的快速发展,生物化学的理论和技术被广泛应用于各种研究领域.因此不断提高教师的业务素质、采用先进的教学手段和教学模式、改革生物化学的实验教学,是提高与保证生物化学教学质量的前提,也是衔接后期研究生教学的重要环节.